Introduction

Cognitive Behavioral Therapy (CBT) is used primarily in psychosocial settings for occupational therapy, however, it can also be used in other settings such as with pediatrics, adults, and geriatrics. Studies have shown to be effective with many conditions including depression, anxiety, and even insomnia.

Theory

Thoughts > Feelings > Behavior

One’s thoughts, feelings, and behavior have a cause and effect relationship.

The goal is to change one’s thinking to influence one’s feelings (from negative to positive) and therefore one’s behavior.

Intervention

Clients may enroll in a program, work with a therapist, or use self-study methods (such as workbook, tapes, and videos) to implement CBT.

For CBT to be effective, one must practice and put in effort to challenge one’s thoughts.

Negative thinking and negative beliefs lead to unpleasant emotional feelings such as anger, hopelessness, depression, sadness, frustration, anger.

Challenging Cognitive Distortions

  • All or nothing thinking
  • Overgeneralization
  • Mental Filter
  • Discounting the Positives
  • Jumping to Conclusions
  • Magnification or Minimization
  • Emotional Reasoning
  • Should Statements

Examples of OT Responses

“What would you think instead when that happens?”

“What would you say to yourself in that situation?”

“What is another way to look at this when this happens?”

OT Treatment

  • CBT is essentially changing the brain through the learning of new thoughts and thought processes.
  • Educate and work with clients to acknowledge their irrational ideas and negative thoughts.
  • Use logic and specific examples with the client to demonstrate the “illogical” nature of the client’s thinking.
  • Replace the illogical and negative with positive thoughts and ideas.
  • To be successful, client must utilize and practice CBT strategies when situations arise or when they are encountered in the natural environment.
  • Homework and journals
  • Role-playing
  • Assertiveness training
  • Cognitive change is a gradual process and will take time (not an instant fix).
  • As CBT does not address underlying pathology, clients often benefit from combined interventions, e.g. medication, stress management, relaxation, mindfulness, etc.

 

See also DBT (Dialectic Behavioral Therapy). Clients often start with CBT before DBT.